A Triple-Drug Combination to Prevent Nausea and Vomiting Following BEAM Chemotherapy Before Autologous Hematopoietic Stem Cell Transplantation

Pielichowski, Wojciech; Barzal, J; Gawroński, Krzysztof; Młot, Beata; Oborska, Sylwia; Waśko-Grabowska, Anna; Rzepecki, Piotr

doi:10.1016/j.transproceed.2011.08.010

Cited by 23 publications

(20 citation statements)

References 15 publications

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“…This difference was significant both when a shorter (up to 7 days after chemotherapy) and a longer period (up to 17 days after chemotherapy) was analyzed. This adds to earlier findings on uncontrolled delayed nausea and vomiting in other settings, although in these studies the measurements of vomiting and occasions of vomiting stopped at an earlier stage (3-5 days after HDCT) and addition of aprepitant was given fewer days after chemotherapy [17,18]. Whereas previous studies with aprepitant in this setting have resulted in a proportion of patients relieved of vomiting (approx.…”

Section: Discussionmentioning

confidence: 83%

Addition of Aprepitant (Emend®) to Standard Antiemetic Regimen Continued for 7 Days after Chemotherapy for Stem Cell Transplantation Provides Significant Reduction of Vomiting

Svanberg¹,

Birgegård²

2015

Oncology

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Chemotherapy-induced nausea/vomiting (CINV) is a major problem for patients treated with high-dose chemotherapy (HDCT) conditioning before stem cell transplantation (SCT), both during chemotherapy and afterwards (delayed nausea/vomiting). The standard of care (5-HT₃ antagonist and dexamethasone) appears to be ineffective against delayed nausea and vomiting. The objective of this study was to compare standard antiemetic treatment with standard treatment plus prolonged treatment with aprepitant (Emend®) until 7 days after the end of chemotherapy in patients treated with HDCT before autologous SCT. Ninety-six patients were randomized to the experiment (EXP) group receiving Emend in addition to standard antiemetics or to the control (CTR) group receiving placebo. Emend or placebo treatment started 1 h before the first HDCT dose for SCT and ended 7 days after HDCT. Thirty-eight patients in the EXP group experienced complete response (no vomiting) compared to 16 patients in the CTR group. There was a significant difference between the EXP (0.63 ± 2.71) and the CTR (3.72 ± 4.91) group during 10 days after the end of HDCT (p = 0.001) with regard to the number of vomiting episodes. No difference with regard to days of nausea or in the use of antiemetic rescue was noted between the groups. We conclude that standard antiemetic treatment can be improved by addition of aprepitant continued for 7 days after the end of chemotherapy.

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Section: Discussionmentioning

confidence: 83%

Addition of Aprepitant (Emend®) to Standard Antiemetic Regimen Continued for 7 Days after Chemotherapy for Stem Cell Transplantation Provides Significant Reduction of Vomiting

Svanberg¹,

Birgegård²

2015

Oncology

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“…First, some of these studies only report outcomes with a single cohort of patients who received aprepitant and do not provide a comparator group or statistical analysis, thus limiting the interpretation of the results. [17][18][19]23,24 While one randomized study comparing 24 patients who received aprepitant plus ondansetron and dexamethasone to 24 patients who only received ondansetron and dexamethasone found no difference in nausea control or CR, this has only been published in abstract form to date. 25 Recently, the first randomized, placebo-controlled study of aprepitant in patients undergoing autologous HSCT reported an improvement in CR in the aprepitant plus granisetron and dexamethasone arm versus granisetron and dexamethasone alone (58% vs. 41%, p < 0.0042).…”

Section: Discussionmentioning

confidence: 99%

Fosaprepitant for the prevention of nausea and vomiting in patients receiving BEAM or high-dose melphalan before autologous hematopoietic stem cell transplant

Clark

Clemmons

Schaack

et al. 2015

J Oncol Pharm Pract

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“…Since that presentation, there have been several phase II studies also suggesting that the observed response rates with transplant regimens may be superior to ones previously reported in the literature [17,19,20]. Although the results seem promising, even within phase II trials that include aprepitant, the response rates can vary substantially indicating the importance of conducting randomized trials before an evidence-based recommendation can be made about the role of an NK 1 receptor antagonist.…”

Section: Emesis Due To Stem Cell Transplant Preparative Regimensmentioning

confidence: 94%

Management of highly emetogenic chemotherapy

Warr¹

2012

Current Opinion in Oncology

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The major guideline groups recommend a combination of a 5-HT3 receptor antagonist, dexamethasone and aprepitant ('triple therapy') for treatment categorized as highly emetogenic. Recent data suggest that, although classified as highly emetogenic, palonosetron may provide very good control of emesis for CHOP and ABVD. Guidelines have not made firm recommendations for highly emetogenic chemotherapy administered over several days or stem cell transplant preparative regimens due to the lack of published randomized trials. Although well tolerated and effective, many patients receive suboptimal antiemetic therapy that includes aprepitant.

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A Triple-Drug Combination to Prevent Nausea and Vomiting Following BEAM Chemotherapy Before Autologous Hematopoietic Stem Cell Transplantation

Cited by 23 publications

References 15 publications

Addition of Aprepitant (Emend®) to Standard Antiemetic Regimen Continued for 7 Days after Chemotherapy for Stem Cell Transplantation Provides Significant Reduction of Vomiting

Addition of Aprepitant (Emend®) to Standard Antiemetic Regimen Continued for 7 Days after Chemotherapy for Stem Cell Transplantation Provides Significant Reduction of Vomiting

Fosaprepitant for the prevention of nausea and vomiting in patients receiving BEAM or high-dose melphalan before autologous hematopoietic stem cell transplant

Management of highly emetogenic chemotherapy

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